Fig. 8

Case 8. Fovea-involving peripheral Coats-like disease in a 50-year-old man who slept in the nasal-down position before and during treatment (inset). A A color fundus image shows the chronic gravitational lipid exudation affecting the fovea inferonasally and inferotemporally; the visual acuity (VA) was 20/40. Near-infrared and fluorescein angiography show the areas of leakage inferonasally and around the fovea. Optical coherence tomography angiography shows the telangiectatic leaking vessels, especially at the level of the perifoveal deep capillary plexi. Structural spectral-domain optical coherence tomography confirms the presence of foveal and parafoveal edema and intraretinal hyperreflective exudates (arrows). B Three months after receiving monthly 1.25-mg intravitreal bevacizumab injections and two sessions of micropulse laser application, despite the partial resolution of the yellow exudates and subfoveal fluid, there are more sites of telangiectatic perifoveal vessels (arrow). C Despite the recommendation of changing the sleep position and using intraocular steroids, the patient returned 3 months later with VA of 20/400 and progression of exudates nasally toward the fovea